KENNETH S MARVIN MD NPI 1417035221

NPI Information

NPI: 1417035221
Provider Name: KENNETH S MARVIN, MD
Classification: Internal Medicine - 207RC0000X
Entity Type: Individual

Specialization: Cardiovascular Disease

Organization: BASSETT HEALTHCARE

PECOS Registration: Yes

Address:
101 HARRIS INDUSTRIAL BLVD
SUITE A
VIDALIA, GA
ZIP 30474
Phone: (912) 535-3500
Get Directions

Kenneth S Marvin, MD is a cardiovascular disease internal medicine in Vidalia, GA with 38 years of experience. The provider is an internist who specializes in diseases of the heart and blood vessels and manages complex cardiac conditions such as heart attacks and life-threatening, abnormal heartbeat rhythms. Kenneth S Marvin, MD NPI is 1417035221. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: STATE UNIVERSITY OF NEW YORK DOWNSTATE MEDICAL CENTER
Graduation Year:1986

The provider's business location address is:

101 HARRIS INDUSTRIAL BLVD
SUITE A
VIDALIA, GA
ZIP 30474-852
Phone: (912) 535-3500

The NPI 1417035221 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/1/2006 and was last updated on 6/10/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207RC0000X	Internal Medicine	Cardiovascular Disease	171074	NEW YORK	Yes
2	207RC0000X	Internal Medicine	Cardiovascular Disease	075321	GEORGIA	No

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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